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Relax and take note of this!

Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...

Homo digitalis during COVID-19?

The COVID-19 pandemic has affected all aspects of our lives. We have seen huge changes in the health service, medical practice and hospital working. Many urology meetings – national and international – were cancelled and seminars and courses have become...

The case against omitting systematic biopsy in younger men

In this issue of European Urology, Al-Monajjed et al. report findings from the PROBASE trial, which evaluated prostate cancer (PC) detection in men aged 45–50 years with PSA ≥3ng/ml using both MRI-targeted biopsy (TBx) and systematic biopsy (SBx). Among 525...

Systematic reviews and meta-analysis – a stepwise approach

As per Cochrane definition (2013), a systematic literature review (SR) attempts “to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question” [1]. A meta-analysis (MA) is a statistical assessment of...

Clinical Trials 2 – key papers

Clinical Trials 1 is available here. Case 1 This British study on haematuria clinic diagnostic yield was published in the British Journal of Urology International in 2006. The results are often asked in examinations! Edwards TJ, et al. A prospective...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

The value of Urolink: an OOPE experience

I was fortunate enough to be able to take some time out of my training after ST5 to pursue an Out Of Programme Experience (OOPE) year. During the Urolink meeting at the British Association of Urological Surgeons (BAUS) 2017 conference...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...

Frequency-volume chart apps for nocturia: keeping urologists up at night

Background Nocturia is a bothersome symptom and the leading cause of disturbed sleep in adults. It is extremely common, with 55% of men and 60% of women aged 50 waking at least once in the night, with a further 20%...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...

Should it be a mandatory requirement for medical students to receive the COVID-19 vaccine to attend clinical attachments?

The vast majority of medical students have positive attitudes towards the COVID-19 vaccine for themselves and patients, however, what about the small inevitable minority who resist it? Should they be prevented from attending clinical attachments in the NHS? It is...